Efficacy of Kangaroo Mother Care on Thermoregulation in Preterm Neonates

Abstract

Preterm and low-birth-weight neonates face a disproportionate risk of hypothermia due to a high surface-area-to-mass ratio, minimal subcutaneous fat, and immature nonshivering thermogenesis, and hypothermia remains an independent, mechanistically well-characterized contributor to neonatal mortality worldwide. Kangaroo mother care (KMC) -- continuous or near-continuous skin-to-skin contact between an infant and a parent's bare chest -- was developed in Bogota, Colombia as a response to incubator scarcity and has since become one of the most extensively trialed interventions in neonatal medicine. This article synthesizes the literature on KMC's specific efficacy for thermoregulation, from the physiology of neonatal heat loss through the foundational Cochrane and Pediatrics meta-analyses, which report hypothermia risk ratios of roughly 0.28 to 0.48 favoring KMC over conventional incubator or crib care, to large recent randomized trials of immediate KMC initiated before full clinical stabilization. We give particular attention to a genuine open question the recent trial literature has surfaced: whether immediate KMC confers uniform benefit across the full range of clinical stability at birth, or whether its optimal timing differs for the most acutely unstable neonates. Read together, the evidence supports KMC as a thermally efficacious, physiologically well-grounded practice, while leaving implementation coverage, transport-phase protocols, and population-specific timing guidance as an active research and health-systems agenda.